Medical ethics and law (MEL) is a vital part of medical education. A strong foundation in MEL enables doctors to manage the professional dilemmas they face – especially in times of crisis, when formal guidance can be outdated or contradictory across professional boundaries. Dr Papanikitas noted the need for enhanced MEL training as a GP trainee, when his own undergraduate theoretical training proved insufficient for the dilemmas of practice.
Collaborating with Dr John Spicer, Head of Primary Care Education for Health Education England in South London, he developed the Primary Care Ethics Handbook, which offers insights from regulators, academics, clinicians and others on the range of dilemmas GPs may encounter. The book was commended by Wendy Rogers, Professor of Clinical Ethics, Macquarie University, for offering ‘something for everyone’ with guidance and insights for both practitioners and patients. The book won a British Medical Association Book Award in 2018.
Papanikitas’s TORCH Knowledge Exchange Fellowship in 2018-9 allowed him to look beyond general practice to explore post-graduate ethics education in other medical specialities. A pilot review of the Gerontology and Palliative Care curricula revealed huge differences in approach and content – and clear opportunities for useful knowledge exchange across medical specialities, and between the profession and academia. The award has also enabled Papanikitas to collaborate with Fellow Early Career Researchers – Dr Selena Knight at KCL, Dr Benedict Hayhoe at Imperial College, and Guy Schofield at Bristol.
Working with Health Education England, the General Medical Council, the Royal Colleges and others through a series a knowledge exchange workshops, Papanikitas and Spicer have built a strong network of those interested in strengthening provision of ethics education after medical school. One output from this (with Knight, Hayhoe and other colleagues) is a pilot study of the needs of clinical commissioners with regard to ethics education. The paper is currently in press with the British Journal of General Practice.
Insights from the workshops have informed a GP training event in Watford and a special parallel session on post-graduate ethics education at the July 2019 Institute of Medical Ethics annual research and education conference. Papanikitas now seeks further funding to extend his review of post-graduate curricula and continue to promote robust MEL provision across all medical specialisms.
He says: ‘Good ethics education equips doctors with the tools to manage the challenges they inevitably face in practice. Strengthening MEL is vital to preventing the stress and ‘moral distress’ we increasingly see in the profession, enabling doctors to practice with professionalism and confidence, and ensuring high-quality care for patients. It also gives doctors the confidence and language to challenge environmental factors that hinder ethical practice.
'Dr Andrew Papanikitas is an Oxford-based GP and a part-time Honorary Tutor at the Nuffield Department of Primary Health Care Sciences ‘The knowledge exchange work we have done with Oxford University has been essential to building the tools and support needed to transform the provision of post-graduate medical ethics education.’ John Spicer, Head of Primary Care Education for Health Education England in South London
Dr Papanikitas has been funded in this work by the National Institute of Healthcare Research, The Institute of Medical Ethics, TORCH, and the Collaborating Centre for Values Based Practice at St Catherine’s College Oxford as well as a Junior Research Fellowship at Harris Manchester College, Oxford.
Knowledge Exchange Fellowships Brochure